Proximal fractures of the humerus are fractures often related to osteoporosis, which occurs frequently in elder people. A proximal fracture of the humerus results in two or more fractured bone fragments. These bone fragments may comprise the humeral head, the humeral shaft, and the greater or lesser tuberosity.
If the bone fragments of the broken humerus are still properly positioned after the fracture, the patient may be successfully treated without surgery. If the bone fragments are dislocated, the position of the bone fragments is often unfavourable so that non-operative treatment would lead to incorrectly or no growing together of the bone fragments.
In those cases the results are generally quite poor and lead to permanent stiffness, pain and limitation of shoulder movements and possibly invalidity of a person. Subsequent interventions to this problem generally do not provide further improvement. Re-operations for bone fractures of a humerus fracture which are not or incorrectly grown together, rarely lead to good results.
A proper reconstruction of the humerus, wherein the bone fragments are relocated to and fixed substantially in their original positions is an important aspect in the treatment of humerus fractures. A fracture in a good position gives a significantly better result than a fracture healing in a bad position.
Various techniques for surgical treatment are used, such as pin- or plate osteosynthesis, K-wire osteosynthesis, screw fixation, suture techniques (cerclage) and treatment by placement of a shoulder prosthesis. Although these techniques are used successfully in some cases, relatively high rates of complications and problems are described in literature. In the existing fixation techniques is frequently seen that the surgery is not sufficient.
Reasons for a low success rate of operation results are for example the weak bone of the humerus in older people, the weak structure of the humerus in general (not weight-bearing joint), the disruption of the vascularization (blood flow) of the humeral head due to the fracture and the difficult surgical technique.
In view of the problems encountered in the known techniques for reconstruction of the humerus in the treatment of a humeral fracture, there is a need to provide new techniques for reconstruction of the humerus, which make proper and reliable reconstruction of the humerus possible.